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The 5-stage model of death was developed by Elizabeth Kubler-Ross. This model identifies the five stages that terminally ill people experience when they are faced with the reality of their own death in the near future. Elizabeth Kubler-Ross was a psychiatrist at the University of Chicago. Based on her research and interactions with more than 200 dying patients during the 1960s, she identified five stages of dying that people experience when they are faced with their own impending death. She wrote about these stages in her book On Death and Dying.

While the stages are listed in order, they do not necessarily occur in the same sequence with every individual. More than one stage may be present at the same time as well.

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Stage 1

Denial is Stage 1. During this stage, the dying patient’s response may be something like, ‘It cannot be true’ or, ‘This cannot be happening to me.

‘ He or she may even accuse the doctor of making a mistake or being incompetent. He or she will often seek advice from another professional or doctor, and some even seek help from faith healers and look for miracle cures. Other individuals will completely deny the diagnosis and go on with their lives as if nothing is wrong. Most people will begin to gradually accept the reality, but there are some who maintain denial until the very end.

Stage 2

The second stage is known as anger. As the individual moves into Stage 2, they become quite angry and hostile and develop a ‘Why me?’-type attitude. These patients will be very resentful and irritable and will fight with family, doctors, and anyone who is trying to help them.

Stage 3

Stage 3 is called bargaining. As a terminally ill patient begins to understand that his or her death is coming, he or she often tries to bargain for some type of relief. For example, the patient might say to whatever god they believe in, ‘If you just let me live six more months to attend my son’s graduation, I will leave all of my money to the church or temple.

‘ It is interesting to note that very often, when those patients do live to that point and beyond, they rarely honor that agreement.

Stage 4

Stage 4 is known as depression. Once patients have lost hope that living a long life is actually possible and realized that death is a reality, they tend to become depressed. The depression can be a result of guilt about choices that they made in their lives, over leaving everyone and everything behind, or from shame over their inability to die with dignity, if that is the case.

Some patients will need to feel this extreme sadness in order to work through it, while others need support from loved ones in order to improve their self esteem.

Stage 5

The final stage is acceptance. Once the patient has worked through denial, anger, bargaining, and depression, he or she is now tired and weak and ready to accept his or her fate.

This is the time for loved ones to be present to hold the person’s hand and show that the experience does not have to be frightening.It is important to note all people are individuals and may have varied reactions to the news that death is looming. While the five stages do include a variety of emotions, they are not meant to identify the only feelings that are experienced by terminally ill patients and there is no one right reaction for everyone.

Learning Outcomes

After reading through the lesson, you should be able to:

  • Recognize who Elizabeth Kubler-Ross was and what her contribution was to near-death research
  • List the five stages of dying
  • Explain the details of each stage
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